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ferriswheel

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About ferriswheel

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  1. That's what was confusing to me. Total occupational impairment but...I work? Granted I work a federal position that would make any accommodations that I needed and it's almost impossible to be fired (especially for disabled vets). That part was really bugging me though. My career is noted in the full text - maybe that will have some merit towards the rating? I appreciate the response.
  2. Hello, I recently completed a c&p exam which concluded two mental disorders (MDD and GAD). I'm currently rated at 30% for mental health for about 6 years now (total of 40%). I can't stop thinking about what the results will be for this exam and would appreciate some insight on some seemingly "scattered" results in regards to severity. Some things appear to have been omitted while other details appear to be input incorrectly. Thanks for the help. Here's what I have. It's not the entire thing...I'm just really hesitant on posting certain things online that shows any kind of PII (even though this is anonymous.) 1. Diagnosis ------------ a. Does the Veteran now have or has he/she ever been diagnosed with a mental disorder(s)? [X] Yes [ ] No ICD code: F41.1 If the Veteran currently has one or more mental disorders that conform to DSM-5 criteria, provide all diagnoses: Mental Disorder Diagnosis #1: Generalized anxiety disorder with panic attacks, severe ICD code: F41.1 Comments, if any: The veteran is service connected for social phobia which is now diagnosed as generalized anxiety disorder with panic attacks, which is considered to be a progression of his previous diagnosis of social phobia. The veteran's current diagnosis of generalized anxiety disorder with panic attacks subsumes his anxiety condition and sleep disturbances, as well as his symptoms of social phobia. Mental Disorder Diagnosis #2: Major depressive disorder, severe ICD code: F33.2 Comments, if any: Major depressive disorder is a new diagnosis for compensation purposes, and is at least as likely as not (greater than 50/50 probability) related to his diagnosis of generalized anxiety disorder. The veteran's major depressive disorder symptoms of helplessness, hopelessness and worthlessness are all related to his severe level of anxiety. The veteran's diagnosis of major depressive disorder subsumes his major depression and depressive neurosis. b. Medical diagnoses relevant to the understanding or management of the Mental Health Disorder (to include TBI): Chronic back issues interefere with his level of sleep. 3. Occupational and social impairment ------------------------------------- a. Which of the following best summarizes the Veteran's level of occupational and social impairment with regards to all mental diagnoses? (Check only one) [X] Total occupational and social impairment b. For the indicated occupational and social impairment, is it possible to differentiate which impairment is caused by each mental disorder? [ ] Yes [X] No [ ] Not Applicable (N/A) If no, provide reason Both diagnoses are comorbid and both equally affect functioning. 3. Symptoms ----------- For VA rating purposes, check all symptoms that actively apply to the Veteran's diagnoses: [X] Depressed mood [X] Anxiety [X] Near-continuous panic or depression affecting the ability to function independently, appropriately and effectively [X] Chronic sleep impairment [X] Mild memory loss, such as forgetting names, directions or recent events [X] Gross impairment in thought processes or communication [X] Disturbances of motivation and mood [X] Difficulty in establishing and maintaining effective work and social relationships [X] Difficulty in adapting to stressful circumstances, including work or a worklike setting [X] Intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene 6. Competency ------------- Is the Veteran capable of managing his or her financial affairs? [X] Yes [ ] No 7. Remarks (including any testing results), if any: --------------------------------------------------- The diagnoses obtained were based on the criteria contained in DSM-5. The veteran's psychological testing was valid and consistent with his report today. He does report passive suicidal ideation, and stated he has no intent to harm himself. He stated that several years ago he pawned his handgun. No other weapons at home. He cited his daughter as a protective factor, even though his ex-wife does not allow him to see her (and it may be that his ex-wife is using the veteran's anxiety to deny him his right to see his daughter as it is difficult for him to effectively communicate within a public setting such as a court hearing and to a judge given his significant level of anxiety and panic). No current active suicidal or homicidal ideation was noted. The veteran has the national suicide hotline number for the VA. Treatment options were specifically discussed, and he stated he would contact <blank> for medication management. Given the veteran's level of anxiety which impairs his ability to communicate by phone, I also contacted <blank> and she f/u with me, stating she made an apt. for the veteran and he would be contacted as to the time of this apt. She also noted his difficulty with phone communication. The veteran's "intermittent inability to perform the activities of daily living" noted above, as well as the "gross impairment of communication" refers to the issue he has with effective communication given his level of anxiety. These symptoms, along with his near continuous level of panic which impairs his ability to function effectively, indicates significant impairment for the veteran, even though he is managing to work full time at this point. His ability to be effective at his job or at school is considered to be impaired given his level of generalized anxiety disorder. Application for vocational rehabilitation is noted in VBMS. He did have to drop out a college due to his inability to perform public speaking. Given the severity of his anxiety and now major depressive disorder as well, with the addition of mental health treatment and continued medication management, his prognosis for improvement is likely oonly fair.
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